Abdominal Massage to Prevent Postoperative Ileus After Colorectal Surgery (MATRAC)

Grenoble Alpes University Hospital Center (CHU)

Status: Completed

Conditions: Colorectal Surgery

Treatments: Procedure: Usual physiotherapeutic intervention and Abdominal Massage

Study type: Interventional

Funder types: Other

Identifiers

NCT04462705

38RC20.021

Details and patient eligibility

About

Post operative ileus refers to an disrupt in normal gastrointestinal motility responsible of nausea and vomiting. It occurs in about 15-20% of colorectal surgeries. Some preventive measures have been included in the Enhanced Recovery After Surgery Program such as early mobilisation and enteral feeding or minimal invasive approach.

Abdominal massage is not widely applied amongst general surgery team and is not part of the recommendation. This technique refers to profound manœuvrers of visceras through abdominal palpation and breathing, and has been used as part of the local protocol of Grenoble Alps University Hospital for many years with satisfactory results. No complications have been reported.

Various studies have evaluated the value of physiotherapy and massage for resumption of normal bowel function. A study from Rouen University Hospital demonstrated that a mechanical stress to the cuteaneous tissue by LPG Cellu M50® machine would reduce pain and lower the time to first flatus. Similar results were obtained after Cardiac surgery. In a preclinical study on operated rats, abdominal massage also improved normal bowel function recovery.

Physiotherapist plays a key role in RAC. Their action on respiratory function (movement of diaphragm) and musculoskeletal system (early walking) allows a faster recovery and a reduction of time of hospitalization. Even though the results on time to first flatus and anxiety seem interesting, Deep abdominal massage has never been evaluated.

Enrollment: 36 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients >18years (homme et femme de plus de 18 ans)
• Elective Patients undergoing colorectal surgery with intestinal anastomosis (Colectomy, Anterior Resection, intestinal resection or stoma closure) without protective stoma creation in an Enhanced Recovery After Surgery Program
• Able to give the consent
• Affiliated to Social Security

Exclusion criteria

• Mental disorders
• Cutaneous infection on the abdomen
• Pregrancy and breast feeding
• Patients unable to give their free consent (incarcerated, legal protection measures)

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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36 participants in 2 patient groups

Usual physiotherapeutic intervention

Active Comparator group

Description:

the usual physiotherapeutic intervention (respiratory and walking exercices). Each patients will be treated following the ERAS Guideline. - At D + 1 post-surgical: 1. - First lift with verticalization. 2. - A session with the Cliniflo® in a seated position. 3. - Walk at least 100 m with the help of the physiotherapist. At- D+2 and D+3 post-surgical Same session as on D+1 with progressive increase in the walking perimeter. Add up and down stairs on D+ 3

Treatment:

Procedure: Usual physiotherapeutic intervention and Abdominal Massage

abdominal massage and usual physiotherapeutic intervention

Experimental group

Description:

the usual physiotherapeutic intervention (respiratory and walking exercices). Each patients will be treated following the ERAS Guideline. - At D + 1post-surgical: 1. - First lift with verticalization. 2. - A session with the Cliniflo® in a seated position. 3. - Walk at least 100 m with the help of the physiotherapist. At- D + 2 and D + 3 post-surgical Same session as on D + 1 with progressive increase in the walking perimeter. Add up and down stairs on D+ 3 In this experimental arm, a abdominal massage will be performed in addition to the usual physiotherapeutic intervention (respiratory and walking exercices). The sessions take place on D+1, D+2 and D+3 post-surgical The first session is performed at least 20 hours after surgery (incision begins) Never within an hour of a meal. The session is timed.

Treatment:

Procedure: Usual physiotherapeutic intervention and Abdominal Massage